A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine, rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines

A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine, rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines

A61K31/537—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine, rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines spiro-condensed or forming part of bridged ring systems

C—CHEMISTRY; METALLURGY

C07—ORGANIC CHEMISTRY

C07D—HETEROCYCLIC COMPOUNDS

C07D471/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00

C07D471/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00 in which the condensed system contains two hetero rings

C07D471/10—Spiro-condensed systems

C—CHEMISTRY; METALLURGY

C07—ORGANIC CHEMISTRY

C07D—HETEROCYCLIC COMPOUNDS

C07D498/00—Heterocyclic compounds containing in the condensed system at least one hetero ring having nitrogen and oxygen atoms as the only ring hetero atoms

C07D498/02—Heterocyclic compounds containing in the condensed system at least one hetero ring having nitrogen and oxygen atoms as the only ring hetero atoms in which the condensed system contains two hetero rings

The neurotransmitter acetylcholine binds to two types of cholinergic receptors: the ionotropic family of nicotinic receptors and the metabotropic family of muscarinic receptors. Muscarinic receptors belong to the large superfamily of plasma membrane-bound G protein coupled receptors (GPCRs). To date, five subtypes of muscarinic receptors (M1-M5) have been cloned and sequenced from a variety of species, and show a remarkably high degree of homology across species and receptor subtype. These M1-M5 muscarinic receptors are predominantly expressed within the parasympathetic nervous system which exerts excitatory and inhibitory control over the central and peripheral tissues and participate in a number of physiologic functions, including heart rate, arousal, cognition, sensory processing, and motor control.

The Muscarinic family of receptors is the target of a large number of pharmacological agents used for various diseases, including leading drugs for COPD, asthma, urinary incontinence, glaucoma, Alzheimer's (AchE inhibitors). Despite the large therapeutic value of this family, cholinergic drugs are limited by the lack of selectivity of these agents, with significant activation of the parasympathetic autonomous system and elevated incidence of adverse effects. The molecular cloning of the muscarinic receptors and the identification of the physiological role of specific isoforms using knock-out mice, has recently delineated novel opportunities for selective muscarinic ligands, and has helped to define the selectivity profile that is required for enhanced efficacy and reduced side effects.

There is a need for modulators of muscarinic receptors M1-M5. There is also a need for methods for treating muscarinic receptor-mediated diseases.

There is also a need for modulators of muscarinic receptors that are selective as to subtypes M1-M5.

For purposes of this invention, the chemical elements are identified in accordance with the Periodic Table of the Elements, CAS version, Handbook of Chemistry and Physics, 75th Ed. Additionally, general principles of organic chemistry are described in “Organic Chemistry”, Thomas Sorrell, University Science Books, Sausalito: 1999, and “March's Advanced Organic Chemistry”, 5th Ed., Ed.: Smith, M. B. and March, J., John Wiley & Sons, New York: 2001, the entire contents of which are hereby incorporated by reference.

The term “muscarinic receptor,” without a prefix specifying the receptor subtype, refers to one or more of the five receptor subtypes M1-M5.

The term “modulating” as used herein means increasing or decreasing, e.g. activity, by a measurable amount. Compounds that modulate muscarinic activity by increasing the activity of the muscarinic receptors are called agonists. Compounds that modulate muscarinic activity by decreasing the activity of the muscarinic receptors are called antagonists. An agonist interacts with a muscarinic receptor to increase the ability of the receptor to transduce an intracellular signal in response to endogenous ligand binding. An antagonist interacts with a muscarinic receptor and competes with the endogenous ligand(s) or substrate(s) for binding site(s) on the receptor to decrease the ability of the receptor to transduce an intracellular signal in response to endogenous ligand binding.

As described herein, compounds of the invention may optionally be substituted with one or more substituents, such as are illustrated generally above, or as exemplified by particular classes, subclasses, and species of the invention.

As used herein the term “aliphatic” encompasses the terms alkyl, alkenyl, alkynyl, each of which being optionally substituted as set forth below.

As used herein, an “amido” encompasses both “aminocarbonyl” and “carbonylamino”. These terms when used alone or in connection with another group refers to an amido group such as —N(RX)—C(O)—RY or —C(O)—N(RX)2, when used terminally, and —C(O)—N(RX)— or —N(RX)—C(O)—when used internally, wherein RX and RY are defined below. Examples of amido groups include alkylamido (such as alkylcarbonylamino or alkylaminocarbonyl), (heterocycloaliphatic)amido, (heteroaralkyl)amido, (heteroaryl)amido, (heterocycloalkyl)alkylamido, arylamido, aralkylamido, (cycloalkyl)alkylamido, or cycloalkylamido.

As used herein, an “amino” group refers to —NRXRY wherein each of RX and RY is independently hydrogen, aliphatic, cycloaliphatic, (cycloaliphatic)aliphatic, aryl, araliphatic, heterocycloaliphatic, (heterocycloaliphatic)aliphatic, heteroaryl, carboxy, sulfanyl, sulfinyl, sulfonyl, (aliphatic)carbonyl, (cycloaliphatic)carbonyl, ((cycloaliphatic)aliphatic)carbonyl, arylcarbonyl, (araliphatic)carbonyl, (heterocycloaliphatic)carbonyl, ((heterocycloaliphatic)aliphatic)carbonyl, (heteroaryl)carbonyl, or (heteroaraliphatic)carbonyl, each of which being defined herein and being optionally substituted. Examples of amino groups include alkylamino, dialkylamino, or arylamino. When the term “amino” is not the terminal group (e.g., alkylcarbonylamino), it is represented by —NRX—. RX has the same meaning as defined above.

As used herein, an “aryl” group used alone or as part of a larger moiety as in “aralkyl”, “aralkoxy”, or “aryloxyalkyl” refers to monocyclic (e.g., phenyl); bicyclic (e.g., indenyl, naphthalenyl, tetrahydronaphthyl, tetrahydroindenyl); and tricyclic (e.g., fluorenyl tetrahydrofluorenyl, or tetrahydroanthracenyl, anthracenyl) ring systems in which the monocyclic ring system is aromatic or at least one of the rings in a bicyclic or tricyclic ring system is aromatic. The bicyclic and tricyclic groups include benzofused 2-3 membered carbocyclic rings. For example, a benzofused group includes phenyl fused with two or more C4-8 carbocyclic moieties. An aryl is optionally substituted with one or more substituents including aliphatic [e.g., alkyl, alkenyl, or alkynyl]; cycloaliphatic; (cycloaliphatic)aliphatic; heterocycloaliphatic; (heterocycloaliphatic)aliphatic; aryl; heteroaryl; alkoxy; (cycloaliphatic)oxy; (heterocycloaliphatic)oxy; aryloxy; heteroaryloxy; (araliphatic)oxy; (heteroaraliphatic)oxy; aroyl; heteroaroyl; amino; oxo (on a non-aromatic carbocyclic ring of a benzofused bicyclic or tricyclic aryl); nitro; carboxy; amido; acyl [e.g., aliphaticcarbonyl; (cycloaliphatic)carbonyl; ((cycloaliphatic)aliphatic)carbonyl; (araliphatic)carbonyl; (heterocycloaliphatic)carbonyl; ((heterocycloaliphatic)aliphatic)carbonyl; or (heteroaraliphatic)carbonyl]; sulfonyl [e.g., aliphatic-SO2— or amino-SO2—]; sulfinyl [e.g., aliphatic-S(O)— or cycloaliphatic-S(O)—]; sulfanyl [e.g., aliphatic-S—]; cyano; halo; hydroxy; mercapto; sulfoxy; urea; thiourea; sulfamoyl; sulfamide; or carbamoyl. Alternatively, an aryl can be unsubstituted.

As used herein, an “araliphatic” such as an “aralkyl” group refers to an aliphatic group (e.g., a C1-4 alkyl group) that is substituted with an aryl group. “Aliphatic,” “alkyl,” and “aryl” are defined herein. An example of an araliphatic such as an aralkyl group is benzyl.

As used herein, an “aralkyl” group refers to an alkyl group (e.g., a C1-4 alkyl group) that is substituted with an aryl group. Both “alkyl” and “aryl” have been defined above. An example of an aralkyl group is benzyl. An aralkyl is optionally substituted with one or more substituents such as aliphatic [e.g., alkyl, alkenyl, or alkynyl, including carboxyalkyl, hydroxyalkyl, or haloalkyl such as trifluoromethyl], cycloaliphatic [e.g., cycloalkyl or cycloalkenyl], (cycloalkyl)alkyl, heterocycloalkyl, (heterocycloalkyl)alkyl, aryl, heteroaryl, alkoxy, cycloalkyloxy, heterocycloalkyloxy, aryloxy, heteroaryloxy, aralkyloxy, heteroaralkyloxy, aroyl, heteroaroyl, nitro, carboxy, alkoxycarbonyl, alkylcarbonyloxy, amido [e.g., aminocarbonyl, alkylcarbonylamino, cycloalkylcarbonylamino, (cycloalkylalkyl)carbonylamino, arylcarbonylamino, aralkylcarbonylamino, (heterocycloalkyl)carbonylamino, (heterocycloalkylalkyl)carbonylamino, heteroarylcarbonylamino, or heteroaralkylcarbonylamino], cyano, halo, hydroxy, acyl, mercapto, alkylsulfanyl, sulfoxy, urea, thiourea, sulfamoyl, sulfamide, oxo, or carbamoyl.

As used herein, a “bicyclic ring system” includes 8-12 (e.g., 9, 10, or 11) membered structures that form two rings, wherein the two rings have at least one atom in common (e.g., 2 atoms in common). Bicyclic ring systems include bicycloaliphatics (e.g., bicycloalkyl or bicycloalkenyl), bicycloheteroaliphatics, bicyclic aryls, and bicyclic heteroaryls.

As used herein, a “cycloaliphatic” group encompasses a “cycloalkyl” group and a “cycloalkenyl” group, each of which being optionally substituted as set forth below.

As used herein, “cyclic moiety” includes cycloaliphatic, heterocycloaliphatic, aryl, or heteroaryl, each of which has been defined previously.

As used herein, the term “heterocycloaliphatic” encompasses a heterocycloalkyl group and a heterocycloalkenyl group, each of which being optionally substituted as set forth below.

As used herein, a “heterocycloalkyl” group refers to a 3-10 membered mono- or bicylic (fused or bridged) (e.g., 5- to 10-membered mono- or bicyclic) saturated ring structure, in which one or more of the ring atoms is a heteroatom (e.g., N, O, S, or combinations thereof). Examples of a heterocycloalkyl group include piperidyl, piperazyl, tetrahydropyranyl, tetrahydrofuryl, 1,4-dioxolanyl, 1,4-dithianyl, 1,3-dioxolanyl, oxazolidyl, isoxazolidyl, morpholinyl, thiomorpholyl, octahydrobenzofuryl, octahydrochromenyl, octahydrothiochromenyl, octahydroindolyl, octahydropyrindinyl, decahydroquinolinyl, octahydrobenzo[b]thiopheneyl, 2-oxa-bicyclo[2.2.2]octyl, 1-aza-bicyclo[2.2.2]octyl, 3-aza-bicyclo[3.2.1]octyl, anad 2,6-dioxa-tricyclo[3.3.1.03,7]nonyl. A monocyclic heterocycloalkyl group can be fused with a phenyl moiety such as tetrahydroisoquinoline. A “heterocycloalkenyl” group, as used herein, refers to a mono- or bicylic (e.g., 5- to 10-membered mono- or bicyclic) non-aromatic ring structure having one or more double bonds, and wherein one or more of the ring atoms is a heteroatom (e.g., N, O, or S). Monocyclic and bicycloheteroaliphatics are numbered according to standard chemical nomenclature.

A “heteroaryl” group, as used herein, refers to a monocyclic, bicyclic, or tricyclic ring system having 4 to 15 ring atoms wherein one or more of the ring atoms is a heteroatom (e.g., N, O, S, or combinations thereof) and in which the monocyclic ring system is aromatic or at least one of the rings in the bicyclic or tricyclic ring systems is aromatic. A heteroaryl group includes a benzofused ring system having 2 to 3 rings. For example, a benzofused group includes benzo fused with one or two 4 to 8 membered heterocycloaliphatic moieties (e.g., indolizyl, indolyl, isoindolyl, 3H-indolyl, indolinyl, benzo[b]furyl, benzo[b]thiophenyl, quinolinyl, or isoquinolinyl). Some examples of heteroaryl are azetidinyl, pyridyl, 1H-indazolyl, furyl, pyrrolyl, thienyl, thiazolyl, oxazolyl, imidazolyl, tetrazolyl, benzofuryl, isoquinolinyl, benzthiazolyl, xanthene, thioxanthene, phenothiazine, dihydroindole, benzo[1,3]dioxole, benzo[b]furyl, benzo[b]thiophenyl, indazolyl, benzimidazolyl, benzthiazolyl, puryl, cinnolyl, quinolyl, quinazolyl, cinnolyl, phthalazyl, quinazolyl, quinoxalyl, isoquinolyl, 4H-quinolizyl, benzo-1,2,5-thiadiazolyl, or 1,8-naphthyridyl.

A “heteroaraliphatic (such as a heteroaralkyl group) as used herein, refers to an aliphatic group (e.g., a C1-4 alkyl group) that is substituted with a heteroaryl group. “Aliphatic,” “alkyl,” and “heteroaryl” have been defined above.

As used herein, an “acyl” group refers to a formyl group or RX—C(O)— (such as alkyl-C(O)—, also referred to as “alkylcarbonyl”) where RX and “alkyl” have been defined previously. Acetyl and pivaloyl are examples of acyl groups.

As used herein, an “aroyl” or “heteroaroyl” refers to an aryl-C(O)— or a heteroaryl-C(O)—. The aryl and heteroaryl portion of the aroyl or heteroaroyl is optionally substituted as previously defined.

As used herein, an “alkoxy” group refers to an alkyl-O— group where “alkyl” has been defined previously.

As used herein, a “carbamoyl” group refers to a group having the structure —O—CO—NRXRY or —NRX—CO—O—RZ wherein RX and RY have been defined above and RZ can be aliphatic, aryl, araliphatic, heterocycloaliphatic, heteroaryl, or heteroaraliphatic.

As used herein, a “carboxy” group refers to —COOH, —COORX, —OC(O)H, —OC(O)RX when used as a terminal group; or —OC(O)— or —C(O)O— when used as an internal group.

As used herein, a “haloaliphatic” group refers to an aliphatic group substituted with 1-3 halogen. For instance, the term haloalkyl includes the group —CF3.

As used herein, a “mercapto” group refers to —SH.

As used herein, a “sulfo” group refers to —SO3H or —SO3RX when used terminally or —S(O)3— when used internally.

As used herein, a “sulfamide” group refers to the structure —NRX—S(O)2—NRYRZ when used terminally and —NRX—S(O)2—NRY— when used internally, wherein RX, RY, and RZ have been defined above.

As used herein, a “sulfonamide” group refers to the structure —S(O)2—NRXRY or —NRX—S(O)2—RZ when used terminally; or —S(O)2—NRX— or —NRX—S(O)2— when used internally, wherein RX, RY, and RZ are defined above.

As used herein a “sulfanyl” group refers to —S—RX when used terminally and —S— when used internally, wherein RX has been defined above. Examples of sulfanyls include aliphatic-S—, cycloaliphatic-S—, aryl-S—, or the like.

As used herein a “sulfinyl” group refers to —S(O)—RX when used terminally and —S(O)—when used internally, wherein RX has been defined above. Exemplary sulfinyl groups include aliphatic-S(O)—, aryl-S(O)—, (cycloaliphatic(aliphatic))-S(O)—, cycloalkyl-S(O)—, heterocycloaliphatic-S(O)—, heteroaryl-S(O)—, or the like.

As used herein, a “sulfonyl” group refers to —S(O)2—RX when used terminally and —S(O)2— when used internally, wherein RX has been defined above. Exemplary sulfonyl groups include aliphatic-S(O)2—, aryl-S(O)2—, (cycloaliphatic(aliphatic))-S(O)2—, cycloaliphatic-S(O)2—, heterocycloaliphatic-S(O)2—, heteroaryl-S(O)2—, (cycloaliphatic(amido(aliphatic)))-S(O)2— or the like.

As used herein, a “sulfoxy” group refers to —O—SO—RX or —SO—O—RX, when used terminally and —O—S(O)— or —S(O)—O— when used internally, where RX has been defined above.

As used herein, a “halogen” or “halo” group refers to fluorine, chlorine, bromine or iodine.

As used herein, an “alkoxycarbonyl,” which is encompassed by the term carboxy, used alone or in connection with another group refers to a group such as alkyl-O—C(O)—.

As used herein, an “alkoxyalkyl” refers to an alkyl group such as alkyl-O-alkyl-, wherein alkyl has been defined above.

As used herein, a “carbonyl” refer to —C(O)—.

As used herein, an “oxo” refers to ═O.

As used herein, an “aminoalkyl” refers to the structure (RX)2N-alkyl-.

As used herein, a “cyanoalkyl” refers to the structure (NC)-alkyl-.

As used herein, a “urea” group refers to the structure —NRX—CO—NRYRZ and a “thiourea” group refers to the structure —NRX—CS—NRYRZ when used terminally and —NRX—CO—NRY— or —NRX—CS—NRY— when used internally, wherein RX, RY, and RZ have been defined above.

As used herein, a “guanidine” group refers to the structure —N═C(N(RXRY))N(RXRY) or —NRX—C(═NRX)NRXRY wherein RX and RY have been defined above.

As used herein, the term “amidino” group refers to the structure —C═(NRX)N(RXRY) wherein RX and RY have been defined above.

In general, the term “vicinal” refers to the placement of substituents on a group that includes two or more carbon atoms, wherein the substituents are attached to adjacent carbon atoms.

In general, the term “geminal” refers to the placement of substituents on a group that includes two or more carbon atoms, wherein the substituents are attached to the same carbon atom.

The terms “terminally” and “internally” refer to the location of a group within a substituent. A group is terminal when the group is present at the end of the substituent not further bonded to the rest of the chemical structure. Carboxyalkyl, i.e., RXO(O)C-alkyl is an example of a carboxy group used terminally. A group is internal when the group is present in the middle of a substituent to at the end of the substituent bound to the rest of the chemical structure. Alkylcarboxy (e.g., alkyl-C(O)O— or alkyl-OC(O)—) and alkylcarboxyaryl (e.g., alkyl-C(O)O-aryl- or alkyl-O(CO)-aryl-) are examples of carboxy groups used internally.

As used herein, “cyclic group” includes mono-, bi-, and tri-cyclic ring systems including cycloaliphatic, heterocycloaliphatic, aryl, or heteroaryl, each of which has been previously defined.

As used herein, an “aliphatic chain” refers to a branched or straight aliphatic group (e.g., alkyl groups, alkenyl groups, or alkynyl groups). A straight aliphatic chain has the structure —[CH2]v—, where v is 1-6. A branched aliphatic chain is a straight aliphatic chain that is substituted with one or more aliphatic groups. A branched aliphatic chain has the structure —[CHQ]v— or —[CQQ]v— where Q is hydrogen or an aliphatic group; however, Q shall be an aliphatic group in at least one instance. The term aliphatic chain includes alkyl chains, alkenyl chains, and alkynyl chains, where alkyl, alkenyl, and alkynyl are defined above.

The phrase “optionally substituted” is used interchangeably with the phrase “substituted or unsubstituted.” As described herein, compounds of the invention can optionally be substituted with one or more substituents, such as are illustrated generally above, or as exemplified by particular classes, subclasses, and species of the invention. As described herein, the variables in formulae (I, Ia, and Ib), e.g., R1, R2, and R3, and other variables contained therein encompass specific groups, such as alkyl and aryl. Unless otherwise noted, each of the specific groups for the variables R1, R2, and R3, and other variables contained therein can be optionally substituted with one or more substituents described herein. Each substituent of a specific group is further optionally substituted with one to three of halo, cyano, oxo, alkoxy, hydroxy, amino, nitro, aryl, haloalkyl, and alkyl. For instance, an alkyl group can be substituted with alkylsulfanyl and the alkylsulfanyl can be optionally substituted with one to three of halo, cyano, oxo, alkoxy, hydroxy, amino, nitro, aryl, haloalkyl, and alkyl. As an additional example, the cycloalkyl portion of a (cycloalkyl)carbonylamino can be optionally substituted with one to three of halo, cyano, alkoxy, hydroxy, nitro, haloalkyl, and alkyl. When two alkoxy groups are bound to the same atom or adjacent atoms, the two alkxoy groups can form a ring together with the atom(s) to which they are bound.

In general, the term “substituted,” whether preceded by the term “optionally” or not, refers to the replacement of hydrogen radicals in a given structure with the radical of a specified substituent. Specific substituents are described above in the definitions and below in the description of compounds and examples thereof. Unless otherwise indicated, an optionally substituted group can have a substituent at each substitutable position of the group, and when more than one position in any given structure can be substituted with more than one substituent selected from a specified group, the substituent can be either the same or different at every position. A ring substituent, such as a heterocycloalkyl, can be bound to another ring, such as a cycloalkyl, to form a spiro-bicyclic ring system, e.g., both rings share one common atom. As one of ordinary skill in the art will recognize, combinations of substituents envisioned by this invention are those combinations that result in the formation of stable or chemically feasible compounds.

The phrase “stable or chemically feasible,” as used herein, refers to compounds that are not substantially altered when subjected to conditions to allow for their production, detection, and preferably their recovery, purification, and use for one or more of the purposes disclosed herein. In some embodiments, a stable compound or chemically feasible compound is one that is not substantially altered when kept at a temperature of 40° C. or less, in the absence of moisture or other chemically reactive conditions, for at least a week.

As used herein, an effective amount is defined as the amount required to confer a therapeutic effect on the treated patient, and is typically determined based on age, surface area, weight, and condition of the patient. The interrelationship of dosages for animals and humans (based on milligrams per meter squared of body surface) is described by Freireich et al., Cancer Chemother. Rep., 50: 219 (1966). Body surface area may be approximately determined from height and weight of the patient. See, e.g., Scientific Tables, Geigy Pharmaceuticals, Ardsley, N.Y., 537 (1970). As used herein, “patient” refers to a mammal, including a human. Unless otherwise stated, structures depicted herein are also meant to include all isomeric (e.g., enantiomeric, diastereomeric, and geometric (or conformational)) forms of the structure; for example, the R and S configurations for each asymmetric center, (Z) and (E) double bond isomers, (Z) and (E) conformational isomers, and tautomers. Therefore, single stereochemical isomers as well as enantiomeric, diastereomeric, and geometric (or conformational) mixtures of the present compounds are within the scope of the invention. Unless otherwise stated, all tautomeric forms of the compounds of the invention are within the scope of the invention. Additionally, unless otherwise stated, structures depicted herein are also meant to include compounds that differ only in, the presence of one or more isotopically enriched atoms. For example, compounds having the present structures except for the replacement of hydrogen by deuterium or tritium, or the replacement of a carbon by a 13C- or 14C-enriched carbon are within the scope of this invention. Such compounds are useful, for example, as analytical tools or probes in biological assays.

II. Compounds

Compounds of formula I are useful modulators of muscarinic receptor activity

A. Generic Compounds:

Compounds of the present invention include:

or a pharmaceutically acceptable salt thereof.

X is —NR50— or —O—, wherein R50 is independently hydrogen or an optionally substituted C1-6 aliphatic.

R1 is an optionally substituted aliphatic, an optionally substituted cycloaliphatic, or an optionally substituted heterocycloaliphatic.

In several additional examples, R1 is bridged bicyclic cycloaliphatic, fused bicyclic cycloaliphatic, or spiro bicyclic cycloaliphatic, each of which is optionally substituted. For instance, R1 is optionally substituted 6-9 membered bridged bicyclic cycloaliphatic. In some examples, R1 is bicyclo[2.1.1]hexanyl, bicyclo[3.1.0]hexanyl, bicyclo[2.2.1]heptanyl, bicyclo[2.2.2]octanyl, bicyclo[3.1.1]heptanyl, bicyclo[3.2.1]octanyl, or bicyclo[3.3.1]nonanyl, each of which is optionally substituted with 1-3 of halo, hydroxy, nitro, cyano, aliphatic, alkoxycarbonyl, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof. In alternative examples, R1 is optionally substituted 6-10 membered fused bicyclic cycloaliphatic. However, in several examples, R1 is octahydropentalenyl, octahydro-1H-indenyl, or decahydronaphthalenyl, each of which is optionally substituted with 1-3 of halo, hydroxy, nitro, cyano, aliphatic, alkoxycarbonyl, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof.

In other examples, R1 is optionally substituted 9-12 membered spiro bicyclic cycloaliphatic. For example, R1 is spiro[5.5]undecanyl, spiro[4.5]decanyl, or spiro[5.6]dodecanyl, each of which is optionally substituted.

In some embodiments, R1 is optionally substituted adamantyl.

In alternative embodiments, R1 is optionally substituted heterocycloaliphatic. In several embodiments, R1 is optionally substituted monocyclic or bicyclic heterocycloaliphatic having 1-3 heteroatoms independently selected from N, O, and S.

In several examples, R1 is bridged bicyclic heterocycloaliphatic, fused bicyclic heterocycloaliphatic, or spiro bicyclic heterocycloaliphatic, each of which is optionally substituted.

In several additional examples, R1 is optionally substituted 6-9 membered bridged bicyclic heterocycloaliphatic. For example, R1 is 5-azabicyclo[2.1.1]hexanyl, 7-azabicyclo[2.2.1]heptanyl, or 8-azabicyclo[3.2.1]octanyl, each of which is optionally substituted with 1-3 of halo, hydroxy, nitro, cyano, aliphatic, alkoxycarbonyl, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof.

In several alternative examples, R1 is optionally substituted 9-12 membered spiro bicyclic heterocycloaliphatic. For example, R1 is 1,4-dioxaspiro[4.5]decanyl; 1,4-dioxaspiro[4.4]nonanyl; 1,5-dioxaspiro[5.5]undecanyl; or 6,10-dioxaspiro[4.5]decanyl; each of which is optionally substituted.

In several embodiments, R3 is optionally substituted aliphatic, such as optionally substituted alkyl, optionally substituted alkenyl, or optionally substituted alkynyl. In one group of examples, R3 is straight or branched optionally substituted C1-6 alkyl (e.g., C1-3 alkyl). For example, R3 is methyl, ethyl, propyl, isopropyl, butyl, sec-butyl, tert-butyl, pentyl, hexyl, or neohexyl, each of which is optionally substituted with 1-3 of halo, hydroxy, oxo, cyano, nitro, or alkoxy, acyl, amino, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof. In several embodiments, R3 is cyano.

In another group of examples, R3 is straight or branched optionally substituted C2-6 alkenyl; and in another group of examples, R3 is straight or branched optionally substituted C2-6 alkynyl. For example, R3 is straight or branched C2-6 alkenyl that is optionally substituted with 1-3 of halo, hydroxy, oxo, cyano, nitro, or alkoxy, acyl, amino, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof. In other examples, R3 is straight or branched C2-6 alkynyl that is optionally substituted with 1-3 of halo, hydroxy, oxo, cyano, nitro, or alkoxy, acyl, amino, cycloaliphatic, heterocycloaliphatic, aryl, heteroaryl, or combinations thereof.

In several embodiments, R3 is optionally substituted (aliphatic)oxy. For example, R3 is optionally substituted C1-3 alkoxy. In still other examples, R3 is methoxy, ethoxy, or propoxy, each of which is optionally substituted.

In several embodiments, R3 is —ZCR6, ZC is a bond, and R6 is hydrogen.

4. Group n

n is 0-4. For example, n is 0, 1, 2, 3, or 4.

5. Group X

X is —NR50— or —O—, wherein R50 is independently hydrogen or an optionally substituted C1-6 aliphatic.

In several embodiments, X is —O—.

C. Subgeneric Compounds

Another aspect of the present invention provides compounds of formula Ia that are useful for modulating the activity and/or activities of muscarinic receptor(s) in accordance to formula Ia:

or a pharmaceutically acceptable salt thereof, wherein X, R2, R3, and n are defined in formula I above.

R1a is optionally substituted aliphatic, optionally substituted cycloaliphatic, or optionally substituted heterocycloaliphatic. However, when R1a is substituted aliphatic, R1a is substituted with 1-3 of halo, cyano, nitro, hydroxy, —NH2, optionally substituted alkoxy, optionally substituted cycloaliphatic, or optionally substituted heterocycloaliphatic. However, when R1a is an aliphatic substituted with a monocyclic heterocycloaliphatic, the monocyclic heterocycloaliphatic is not substituted with aryl; and when R1a is an optionally substituted cycloaliphatic, R1a is not substituted with a substituted monocyclic heterocycloaliphic.

Another aspect of the present invention provides compounds of formula Ib that are useful for modulating the activity and/or activities of muscarinic receptor(s) in accordance to formula Ib:

R1b is optionally substituted cycloaliphatic, or optionally substituted heterocycloaliphatic. However, when R1b is optionally substituted cycloaliphatic, R1b is not substituted with a substituted monocyclic heterocycloaliphic.

Another aspect of the present invention provides compounds of formula Ic that are useful for modulating the activity and/or activities of muscarinic receptor(s) in accordance to formula Ic:

or a pharmaceutically acceptable salt thereof, wherein R2, R3, R50, and n are defined in formula I above.

RX is either of R1a or R1b, wherein each of R1a or R1b are described above in formulae Ia and Ib.

In several embodiments, where RX is R1a, and when R1a is an optionally substituted aliphatic, R1a is not substituted with an aryl, heteroaryl, or aryl(oxy); when R1a is an aliphatic substituted with a monocyclic heterocycloaliphatic, the monocyclic heterocycloaliphatic is not substituted with aryl; and when R1a is an optionally substituted cycloaliphatic, R1a is not substituted with a substituted monocyclic heterocycloaliphic.

In several embodiments, where RX is R1b, and when R1b is an optionally substituted cycloaliphatic, R1b is not substituted with a substituted monocyclic heterocycloaliphic.

Another aspect of the present invention provides compounds of formula Ic that are useful for modulating the activity and/or activities of muscarinic receptor(s) in accordance to formula Id:

Wherein RX is described above in formula Ic , and R2, R3, and n are described in formula I, above.

D. Combinations of Embodiments

Other embodiments of the present invention include any combination of R1, R1a, R1b, R2, R3, X, and n.

Compounds of formulae (I, Ia, Ib, Ic, and Id) can be prepared from commercially available starting materials using any methods known in the art. In one method, compounds of formulae (I, Ia, Ib, Ic, and Id) wherein R1 is a an optionally substituted saturated, partially unsaturated, or fully unsaturated 5-10 membered ring system including 0-3 heteroatoms selected from N, O, or S, are prepared according to schemes 1-2 below.

PG is a protecting group, and X is defined above in formula I.

Referring to scheme 1, the starting material (1a), wherein Z is —NH2, is reacted with N-piperidin-4-one 1b) in the presence of an acid, such as polyphosphoric acid, and heat to the 1′H-spiro[piperidine-4,4′-quinazolin]-2′(3′H)-one (1c), as described in Berkhout, Theo A. et al., “CCR2: Characterization of the Antagonist Binding Site from a Combined Receptor Modeling/Mutagenesis Approach,” J. Med. Chem., 46(19), pp. 4070-4086 (2003); Clark, Robin D. et al., “Synthesis and antihypertensive activity of 4′-substituted spiro[4H-3,1-benzoxazine-4,4′-piperidin]-2(1H)-ones,” J. Med. Chem., 26(5), pp. 657-61 (1983); and WO 2005/065779 A1 “Calcitonin Gene Related Peptide Receptor Antagonists”. Alternatively, when Z is —OC(CH3)3, starting material (1a) is reacted with N-protected piperidin-4-one (1b) in the presence of a strong base, such as tert-butyllithium, to produce the spiro[benzo[d][1,3]oxazine-4,4′-piperidin]-2(1H)-one (1c).

Removal of the protecting group (e.g., by treating intermediate (1c) with ammonium formate, MeOH, Pd/C, at room temp or heat; by treating intermediate (1c) with Pd/C, MeOH, and H2; or by treating the intermediate (1c) with TFA, CH2Cl2 at 0° C. to room temperature) produces the free amine (1d). Reductive amination of the amine (1d) provides the compounds of the invention (I). The reaction of amine (1d) with an appropriate aldehyde or ketone under reductive amination conditions (step c), typically using NaBH(OAc)3 in DCE/AcOH/TEA at room temperature, may be used to provide the desired compounds of formula I. For less reactive ketones, more forcing conditions may be used. For example, the treatment of the amine (1d) and the ketone in a neat solution of Ti(OiPr)4, followed by treatment with NaBH4 in MeOH, may be used to provide the desired compounds of formula I. See Abdel-Magid, A. F. et al., “Reductive Amination of Aldehydes and Ketones with Sodium Triacetoxyborohydride. Studies on Direct and Indirect Reductive Amination Procedures,” J. Org. Chem., 61, pp. 3849-3862 (1996) and the references sited therein.

Compounds of formula Ia may be further elaborated by reaction with an alkyl halide in the presence of an appropriate base (step d) to provide additional compounds of formula I. Typically, the secondary amine is reacted with an alkyl iodide, bromide, or chloride in the presence of an appropriate base, either at room temperature, with heat, or under microwave conditions. Bases may be organic such as triethylamine, or inorganic such as Na2CO3 or Cs2CO3. Typical reaction solvents include but are not limited to DMF, acetone, and acetonitrile.

Scheme 2 illustrates alternative conditions as example for the synthesis of compounds of formula I in which R1 is a monocyclic or bicyclic ring system that contains or is substituted with a protected functionality which may be either be retained, deprotected and retained, or deprotected and further elaborated to produce additional compounds of formulae (I, Ia, Ib, Ic, and Id).

Referring to scheme 2, an alternative method of producing compounds of formulae (I, Ia, Ib, Ic, and Id) can include reacting the R2-, R3-substituted benzoxazinone intermediate (2a) with a ketone or aldehyde in the presence of a suitable reducing agent (sodium triacetoxyborohydride, sodium borohydride, or the like) and in the presence of a suitable solvent (e.g., dichloroethane, or the like) at room temperature to produce compounds of formulae (I, Ia, Ib, Ic, and Id). See Example 2, where either R1′ or R1″ is hydrogen and the non-hydrogen R1′ or R1″ includes an alkyl substituted with heterocycloaliphatic or cycloaliphatic.

IV. Formulations, Administrations, and Uses

The present invention includes within its scope pharmaceutically acceptable prodrugs of the compounds of the present invention. A “pharmaceutically acceptable prodrug” means any pharmaceutically acceptable salt, ester, salt of an ester, or other derivative of a compound of the present invention which, upon administration to a recipient, is capable of providing (directly or indirectly) a compound of this invention or an active metabolite or residue thereof. Preferred prodrugs are those that increase the bioavailability of the compounds of this invention when such compounds are administered to a mammal or which enhance delivery of the parent compound to a biological compartment relative to the parent species.

The term “pharmaceutically acceptable carrier, adjuvant, or vehicle” refers to a non-toxic carrier, adjuvant, or vehicle that does not destroy the pharmacological activity of the compound with which it is formulated. Pharmaceutically acceptable carriers, adjuvants or vehicles that may be used in the compositions of this invention include, but are not limited to, ion exchangers, alumina, aluminum stearate, lecithin, serum proteins, such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, polyethylene glycol and wool fat.

Salts derived from appropriate bases include alkali metal (e.g., sodium and potassium), alkaline earth metal (e.g., magnesium), ammonium and N+(C1-4 alkyl)4 salts. This invention also envisions the quaternization of any basic nitrogen-containing groups of the compounds disclosed herein. Water or oil-soluble or dispersible products may be obtained by such quaternization.

The compositions of the present invention may be administered orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir. The term “parenteral” as used herein includes subcutaneous, intravenous, intramuscular, intra-articular, intra-synovial, intrasternal, intrathecal, intrahepatic, intralesional and intracranial injection or infusion techniques. Preferably, the compositions are administered orally, intraperitoneally or intravenously. Sterile injectable forms of the compositions of this invention may be aqueous or oleaginous suspension. These suspensions may be formulated according to techniques known in the art using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium.

For this purpose, any bland fixed oil may be employed including synthetic mono- or di-glycerides. Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant, such as carboxymethyl cellulose or similar dispersing agents that are commonly used in the formulation of pharmaceutically acceptable dosage forms including emulsions and suspensions. Other commonly used surfactants, such as Tweens, Spans and other emulsifying agents or bioavailability enhancers which are commonly used in the manufacture of pharmaceutically acceptable solid, liquid, or other dosage forms may also be used for the purposes of formulation.

The pharmaceutically acceptable compositions of this invention may be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, aqueous suspensions or solutions. In the case of tablets for oral use, carriers commonly used include lactose and corn starch. Lubricating agents, such as magnesium stearate, are also typically added. For oral administration in a capsule form, useful diluents include lactose and dried cornstarch. When aqueous suspensions are required for oral use, the active ingredient is combined with emulsifying and suspending agents. If desired, certain sweetening, flavoring or coloring agents may also be added.

Alternatively, the pharmaceutically acceptable compositions of this invention may be administered in the form of suppositories for rectal administration. These can be prepared by mixing the agent with a suitable non-irritating excipient that is solid at room temperature but liquid at rectal temperature and therefore will melt in the rectum to release the drug. Such materials include cocoa butter, beeswax and polyethylene glycols.

The pharmaceutically acceptable compositions of this invention may also be administered topically, especially when the target of treatment includes areas or organs readily accessible by topical application, including diseases of the eye, the skin, or the lower intestinal tract. Suitable topical formulations are readily prepared for each of these areas or organs.

Topical application for the lower intestinal tract can be effected in a rectal suppository formulation (see above) or in a suitable enema formulation. Topically-transdermal patches may also be used.

For topical applications, the pharmaceutically acceptable compositions may be formulated in a suitable ointment containing the active component suspended or dissolved in one or more carriers. Carriers for topical administration of the compounds of this invention include, but are not limited to, mineral oil, liquid petrolatum, white petrolatum, propylene glycol, polyoxyethylene, polyoxypropylene compound, emulsifying wax and water. Alternatively, the pharmaceutically acceptable compositions can be formulated in a suitable lotion or cream containing the active components suspended or dissolved in one or more pharmaceutically acceptable carriers. Suitable carriers include, but are not limited to, mineral oil, sorbitan monostearate, polysorbate 60, cetyl esters wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water.

For ophthalmic use, the pharmaceutically acceptable compositions may be formulated as micronized suspensions in isotonic, pH adjusted sterile saline, or, preferably, as solutions in isotonic, pH adjusted sterile saline, either with or without a preservative such as benzylalkonium chloride. Alternatively, for ophthalmic uses, the pharmaceutically acceptable compositions may be formulated in an ointment such as petrolatum.

The pharmaceutically acceptable compositions of this invention may also be administered by nasal aerosol or inhalation. Such compositions are prepared according to techniques well-known in the art of pharmaceutical formulation and may be prepared as solutions in saline, employing benzyl alcohol or other suitable preservatives, absorption promoters to enhance bioavailability, fluorocarbons, and/or other conventional solubilizing or dispersing agents.

Most preferably, the pharmaceutically acceptable compositions of this invention are formulated for oral administration.

The amount of the compounds of the present invention that may be combined with the carrier materials to produce a composition in a single dosage form will vary depending upon the host treated, the particular mode of administration. Preferably, the compositions should be formulated so that a dosage of between 0.01-100 mg/kg body weight/day of the modulator can be administered to a patient receiving these compositions.

It should also be understood that a specific dosage and treatment regimen for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drug combination, and the judgment of the treating physician and the severity of the particular disease being treated. The amount of a compound of the present invention in the composition will also depend upon the particular compound in the composition.

Depending upon the particular condition, or disease, to be treated or prevented, additional therapeutic agents, which are normally administered to treat or prevent that condition, may also be present in the compositions of this invention. As used herein, additional therapeutic agents that are normally administered to treat or prevent a particular disease, or condition, are known as “appropriate for the disease, or condition, being treated.”

According to a preferred embodiment, the compounds of formulae (I, Ia, Ib, Ic, and Id) are selective modulators of M1, M2 and M4. More preferably, the compounds of formulae (I, Ia, Ib, Ic, and Id) are selective modulators of M1 and/or M4. Yet more preferably, certain compounds of formulae (I, Ia, Ib, Ic, and Id) are selective modulators of M1. Or, preferably, certain compounds of formulae (I, Ia, Ib, Ic, and Id) are selective modulators of M4.

Applicants believe that the ability of the compounds of the present invention to modulate the activity of muscarinic receptors is derived from the affinity of these compounds to the muscarinic receptors. Such affinity, applicants believe, activates a muscarinic receptor (i.e., an agonist) or inhibits the activity of a muscarinic receptor.

The term “selective” as used herein means a measurably greater ability to modulate one muscarinic receptor subtype when compared to the other muscarinic receptor subtypes. E.g., the term “selective M4 agonist” means a compound that has a measurably greater ability to act as an M4 agonist when compared to that compound's agonist activity with the other muscarinic receptor subtype(s).

According to an alternative embodiment, the present invention provides a method of treating a muscarinic receptor mediated disease in a mammal, such as a human, including the step of administering to said mammal a composition comprising a compound of formulae (I, Ia, Ib, Ic, and Id) or an embodiment thereof as set forth herein.

According to another embodiment, the present invention provides a method of treating a disease mediated by a muscarinic receptor including the step of administering to said mammal a composition comprising a compound of formulae (I, Ia, Ib, Ic, and Id), or other embodiments thereof as set forth above. Preferably, said disease is mediated by M1, or said disease is mediated by M4.

According to yet another embodiment, the present invention provides a method of treating or reducing the severity of a disease in a patient, wherein said disease is selected from CNS derived pathologies including cognitive disorders, Attention Deficit Hyperactivity Disorder (ADHD), obesity, Alzheimer's disease, various dementias such as vascular dementia, psychosis including schizophrenia, mania, bipolar disorders, pain conditions including acute and chronic syndromes, Huntington's Chorea, Friederich's ataxia, Gilles de la Tourette's Syndrome, Downs Syndrome, Pick disease, clinical depression, sudden infant death syndrome, Parkinson's disease, peripheral disorders such as reduction of intra ocular pressure in Glaucoma and treatment of dry eyes and dry mouth including Sjögren's Syndrome, wherein said method comprises the step of contacting said patient with a compound according to the present invention.

According to an alternative embodiment, the present invention provides a method of treating or reducing the severity of a disease in a patient, wherein said disease is selected from pain, psychosis (including schizophrenia, hallucinations, and delusions), Alzheimer's disease, Parkinson's disease, glaucoma, bradycardia, gastric acid secretion, asthma, or GI disturbances.

According to a preferred embodiment, the present invention is useful for treating or reducing the severity of psychosis, Alzheimer's disease, pain, or Parkinson's disease.

All references cited within this document are incorporated herein by reference.

V. Preparations and Examples

In order that the invention described herein may be more fully understood, the following examples are set forth. It should be understood that these examples are for illustrative purposes only and are not to be construed as limiting this invention in any manner.

Cells are harvested at 80-90% confluence using Versene (GIBCO Cat# 15040-066), collected by centrifugation and seeded 18-24 hours prior to running the calcium assay at a density of 5,000-10,000 cells/well in back-walled, clear-bottomed 384-well plates (BD Biocoat, poly-D-lysine, Cat#356663). The day of the experiment, the cells are washed with a plate washer (Bioteck Instruments, ELX 405) using Bath 1 buffer (140-mM NaCl, 4.5-mM KCl, 2-mM CaCl2, 1-mM MgCl2, 10-mM Hepes-Na, 10-mM Glucose, pH 7.4, with NaOH) containing 1 mM Probenecid. Next, the calcium dye Fluo-3 (25 μl/well of Fluo-3 AM at 4 μM, Molecular Probes F-1241, in Bath 1 buffer containing 1 mM Probenecid) is added to the 25 μl of Bath 1 remaining in each well after the plate wash and the dye is loaded at 37° C. in the tissue culture incubator for 60-90 min. The fluorescent dye is removed using the plate washer with Bath 1 containing 1 mM Probenecid, leaving 25 μl/well of this solution after the wash. Alternatively, cells can be loaded with the calcium indicator from Molecular Devices (Calcium 3 Assay Reagents, Cat # R7181) adding 5 μl of a 5× solution dye in Bath 1 containing 1 mM Probenecid (10 ml per dye flask cat# R7182 to generate a solution 20×) to 20 μl of the same buffer. After loading for 60 min, the experiment can be run without having to remove the dye.

Compounds are prepared at a 2× fold concentration in a 96-well plate (round bottom, Costar Corning cat# 3656), by reconstituting the pre-spotted compounds in bath 1 containing 1 mM probenecid. The final concentration DMSO is 0.5%, and the amount of DMSO is normalized across the assay plate. To determine an agonist action of the compounds on muscarinic receptors, the reconstituted compounds are added (25 μl compound/well) to the cell assay plate (containing 25 μl/well) using the multi-channel robotic system of the FLIPR 3 Instrument (Molecular Devices, Sunnyvale, Calif.). To determine a functional inhibitory action of the compounds on muscarinic receptors, the reconstituted compounds are added (25 μl compound/well) to the assay plate and pre-incubated for 15 min prior to adding 25 μl of Carbachol at 3× the EC80 for each muscarinic subtype. Alternatively, the compounds can be co-applied simultaneously with the agonist. In both assay modes, the fluorescence is recorded for 60 sec (excitation wavelength is 488 nM and emission wavelength 540 nm) using the FLIPR 3 instrument.

The potency, efficacy and selectivity of the muscarinic compounds were evaluated by screening the compound activity across the whole family (M1 to M5 cells). Compounds were also screened for activity on other proteins such as other GPCRs and ion channels to determine selectivity on M4 receptors.

The compounds of the present invention were found to modulate the M1 and/or M4 muscarinic receptors selectively over the other receptor types.

Examples of activities and efficacies of the muscarinic compounds of formulae (I, Ia, Ib, Ic, and Id) on modulating M1 and M4 receptors are shown below in Table 3. The compound activity for the M1 and M4 is illustrated with “+++” if activity was measured to be less than 2.0 μM, “++” if activity was measured to be from 2.0 μM to 5.0 μM, “+” if activity was measured to be greater than 5.0 μM, and “−” if no data was available. The efficacy for M1 and M4 modulation is illustrated with “+++” if efficacy was calculated to be greater than 100%, “++” if efficacy was calculated to be from 100% to 25%, “+” if efficacy was calculated to be less than 25%, and “−” if no data was available. It should be noted that 100% efficacy is the maximum response obtained with the Carbachol control.

TABLE 3

Activities and efficacies of compounds of formulae (I, Ia, Ib, Ic, and Id).

M1

M1

M2

M2

M3

M3

M4

M4

Cmpd No

Activity

Efficacy

Activity

Efficacy

Activity

Efficacy

Activity

Efficacy

1

++

++

+

++

+

+

++

++

2

++

++

+

+

+

+

+

++

3

+++

++

+++

++

+++

++

+++

++

4

+++

++

++

++

+

+

+++

++

5

+++

++

+

++

+

+

+++

++

6

++

++

+

+

+

+

+

+

7

+++

++

+++

++

++

++

+++

++

8

+++

++

+++

++

+

++

+++

++

9

+++

++

++

++

+

+

+++

++

10

+

+

+

+

+

+

+

+

11

+++

++

+

++

+

+

+++

++

12

+++

++

+

++

+

+

+++

++

13

+++

++

+++

++

+++

++

+++

++

14

+++

++

+++

++

+++

++

+++

++

15

++

++

+

+

+

+

+

+

16

+++

++

+

+

+

+

+++

++

17

+++

++

+

+

+

+

+++

+

18

+++

++

+

+

+

+

+++

++

19

+++

++

+

++

+

+

+++

++

20

+

++

+

+

+

+

+

++

21

+++

++

+

+

+

+

+++

++

22

+++

++

+++

++

+

++

+++

++

23

+

+

+

+

+

+

+

+

24

+++

++

+

+

+

+

+++

++

25

+++

++

+++

++

+

++

+++

++

26

+++

++

+

+

+

+

+++

+

27

+++

++

++

++

+

+

+++

++

28

+++

++

+++

++

++

++

+++

++

29

+

+

+

+

+

+

+

+

30

+++

++

++

++

+

+

+++

++

31

++

++

+

+

+

+

+++

+

32

+++

++

++

+

+

+

+++

++

33

+

+

+

+

+

+

+++

++

34

+

++

+

+

+

+

+

+

35

+++

++

+

+

+

+

+

+

36

+++

++

+++

++

++

++

+++

++

37

+

+

+

+

+

+

+++

++

38

++

++

+

++

+

+

++

++

39

+++

++

++

+

+

+

+++

++

40

+++

++

++

+

+

+

+++

++

41

+++

++

+

+

+

+

+++

++

42

+++

++

+

+

+

+

+++

++

43

+

+

+

+

+

+

+

+

44

+++

++

++

++

+

+

+++

++

45

++

+

+

+

+

+

+

+

46

+++

++

+++

++

+

+

+++

++

47

+

++

+

+

+

+

+

+

48

+++

++

+++

++

+

++

+++

++

49

+

++

+

+

+

+

+

+

50

+++

++

+

++

+

+

+++

++

51

+

+

+

+

+

+

+

+

52

+++

++

+

+

+

+

++

++

53

+++

++

+++

++

+

++

+++

++

54

+++

++

+

+

+

+

+

+

55

+

++

+

+

+

+

+

+

56

+

++

+

+

+

++

+

+

57

+++

++

+++

++

+

+

+++

++

58

+++

++

+

+

+

+

++

++

59

+++

++

+

+

+

+

+

+

60

+++

++

+++

++

+

++

+++

++

61

+++

++

+

+

+

+

+

++

62

+++

++

+++

++

+++

++

+++

++

63

+++

++

+++

++

+++

++

+++

++

64

++

++

+

++

+

+

++

++

65

+

+

+

+

+

+

+++

++

66

+

++

+

+

+

+

+

+

67

+++

++

+++

++

+

++

+++

++

68

+++

++

+

+

+

+

+

+

69

+++

++

+++

++

+

++

+++

++

70

+++

++

+

+

+

+

+

+

71

++

++

+

+

+

+

+++

++

72

+

+

+

+

+

+

+

+

73

+

++

+

+

+

+

+

+

74

+++

+++

+++

++

+

++

+++

++

75

+++

++

+

+

+

+

+++

++

76

+++

++

+

++

+

+

+++

++

77

+++

++

+

+

+

+

+++

++

78

++

++

+

+

+

+

+++

++

79

+++

++

+

+

+

+

+

+

80

+++

++

+++

++

+

++

+++

++

81

+++

++

+

++

+

+

++

++

82

+++

++

++

++

+

+

+++

++

83

+++

++

+

+

+

+

+++

++

84

+

++

+

+

+

+

+

+

85

+++

++

+++

++

+

+

+++

++

86

+++

+++

+++

++

+++

++

+++

++

87

+++

++

+

+

+

+

++

++

88

+++

++

+

+

+

+

+++

++

89

+++

++

+

++

+

+

++

++

90

+++

++

++

++

+

+

+

+

91

+

+

+

+

+

+

+

+

92

+++

++

+

+

+

+

++

+

93

+++

++

++

++

++

++

+

+

94

−

−

−

−

−

−

−

−

95

−

−

−

−

−

−

−

−

96

−

−

−

−

−

−

−

−

97

−

−

−

−

−

−

−

−

98

−

−

−

−

−

−

−

−

99

−

−

−

−

−

−

−

−

100

−

−

−

−

−

−

−

−

101

−

−

−

−

−

−

−

−

102

−

−

−

−

−

−

−

−

103

−

−

−

−

−

−

−

−

104

−

−

−

−

−

−

−

−

105

−

−

−

−

−

−

−

−

106

−

−

−

−

−

−

−

−

107

−

−

−

−

−

−

−

−

108

−

−

−

−

−

−

−

−

Other Embodiments

It is to be understood that while the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims.

Claims (37)

Each R1a is a group containing at least four carbon atoms and is independently, aliphatic, cycloaliphatic, heteroaliphatic or heterocycloaliphatic, optionally substituted with aliphatic, cycloaliphatic, heteroaliphatic or heterocycloaliphatic, acyl, alkoxycarbonyl, cycloalkoxycarbonyl, heterocycloalkoxycarbonyl or amido, wherein the alkoxycarbonyl can be further substituted with aliphatic;

21. The compound of claim 20, wherein R1a is 1,4-dioxaspiro[4.5]decane-yl; 1,4-dioxaspiro[4.4]nonane-yl; 1,5-dioxaspiro[5.5]undecane-yl; or 6,10-dioxaspiro[4.5]decane-yl; each of which is optionally substituted.